MENDOCINO COAST HEALTH CARE DISTRICT (NPI# 1124220249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124220249 |
| Entity Type | Organization |
| Organization Name | MENDOCINO COAST HEALTH CARE DISTRICT |
| Other Organization Name | MENDOCINO COAST DISTRICT HOSPITAL |
| Practice Address |
721 River Drive Suite A Fort Bragg CA 95437 |
| Mailing Address |
700 River Dr Fort Bragg CA 95437-5403 |
| Practice Telephone | 7079614631 |
| Practice Fax Number | 7079641192 |
| Mailing Telephone | 7079614611 |
| Mailing Fax Number | 7079614794 |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | MR. BOB S. EDWARDS JR. (CEO) |
| Authorized Official Telephone | 7079614610 |
| Authorized Official Credential | FACHE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC0050X |
Clinic/Center Specialization: Critical Access Hospital |
110000040 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Mendocino Coast District Hospital | Doing Business As Name - Organization |
| North Coast Family Health Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710932157 | Mendocino Coast Health Care District | Home Health | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-05-24 |
| 1538113725 | Mendocino Coast Health Care District | General Acute Care Hospital | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-05-20 |
| Street Address |
721 RIVER DRIVE SUITE A |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487665410 | Jason Kirkman | Internal Medicine | 721 River Drive, Suite A, Fort Bragg, CA 95437 | 2006-08-11 |
| 1851754279 | Elizabeth Levine | Internal Medicine | 721 River Drive, Suite A, Fort Bragg, CA 95437-5403 | 2016-04-02 |
| 1003113424 | Valerie Lynn Poirier | Physician Assistant | 721 River Drive, Ste B, Fort Bragg, CA 95437-5403 | 2011-02-21 |
| 1295961837 | Michele Marie Tellier | Nurse Practitioner | 721 River Drive, Suite A, Fort Bragg, CA 95437-5403 | 2009-06-10 |
| 1538394713 | Jennifer Kay Pierce | Physician Assistant | 721 River Drive, Suite A, Fort Bragg, CA 95437-5403 | 2009-05-18 |
| 1114067287 | James William Swallow | Internal Medicine | 721 River Drive, Suite A, Fort Bragg, CA 95437 | 2007-02-07 |
| 1043381072 | James M. Sandys | Family Medicine | 721 River Drive, Suite A, Fort Bragg, CA 95437-5403 | 2006-11-13 |
| 1821199332 | Teresa Ann Mcdonald | Nurse Practitioner | 721 River Drive, Suite A, Fort Bragg, CA 95437 | 2006-09-26 |
| 1124127600 | Sasha Graham | Nurse Practitioner | 721 River Drive, Suite A, Fort Bragg, CA 95437 | 2006-09-21 |
| 1992717920 | Richard Sacks-wilner | Internal Medicine | 721 River Drive, Suite A, Fort Bragg, CA 95437 | 2006-08-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 261QC0050X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Critical Access Hospital |
| An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497298483 | Mayers Memorial Hospital District | Clinic/Center | 20641 Commerce Way, Burney, CA 96013-4380 | 2016-11-23 |
| 1043658990 | Uc Riverside Graduate Medical Education | Clinic/Center | School of Medicine Education Building, 900 University Avenue, Riverside, CA 92521-0001 | 2013-06-12 |
| 1275151334 | Sfv Health Center, Inc. | Clinic/Center | 8426 Sunland Blvd, Sun Valley, CA 91352-3436 | 2020-07-06 |
| 1427599281 | Shawn Mcgowan | Clinic/Center | 1100 N State St, Los Angeles, CA 90033-5000 | 2017-03-13 |
| 1669695185 | John C. Fremont Healthcare District | Clinic/Center | 5189 Hospital Rd, Mariposa, CA 95338-9524 | 2007-04-11 |
| 1346250347 | Avalon Medical Development Corporation | Clinic/Center | 100 Falls Canyon Road, Avalon, CA 90704-1563 | 2006-08-09 |
| 1962444059 | Southern Mono Healthcare District | Clinic/Center | 85 Sierra Park Rd, Mammoth Lakes, CA 93546-2073 | 2006-06-12 |
| City | FORT BRAGG |
| Zip Code | 95437 |
Please comment or provide details below to improve the information on MENDOCINO COAST HEALTH CARE DISTRICT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.